Effects of Mirror Therapy-Based Upper Extremity Exercises After Thoracotomy: A Randomized Controlled Trial.

Abstract

Purpose: To investigate the efficacy of mirror therapy-based upper extremity exercises on shoulder pain, shoulder functions, quality of life, and fear of re-injury.

Design: Single-blind randomized controlled prospective study.

Methods: This prospective randomized controlled study included patients who underwent surgery using the posterolateral-thoracotomy method. Patients were randomly divided into two groups as control (n = 40) and study group (n = 40). Patients were included in the pulmonary rehabilitation program 5 days a week for 4 weeks. In addition, the study group patients performed the upper extremity exercises in the rehabilitation program in front of a mirror. Pain, shoulder joint range of motion, shoulder muscle strength, shoulder function, quality of life, and kinesiophobia were evaluated before surgery and 4 weeks after the intervention.

Results: A statistically significant improvement was observed in the study group when comparing shoulder flexion and abduction muscle strength before surgery (Median; 141; 119) with after 4 weeks (Median; 155; 138) (p = .027; p = .019). When the changes from baseline to 4 weeks were compared, there were statistically significant differences between the groups in all results except shoulder external rotation muscle strength (p < .050).

Conclusions: Mirror therapy-based upper extremity exercises, which is added to the physiotherapy and rehabilitation program after thoracotomy, provides benefits such as pain relief, reduction of kinesiophobia, improvement of shoulder functions and improvement of quality of life.

Clinical implications: Thoracotomy may cause shoulder pain and limitation of shoulder functions. Shoulder pain causes changes in the motor cortex and structural and functional changes that affect muscle activation. Central sensitization plays a role in events such as shoulder pain and dysfunction. Recently, mirror therapy has been used in the treatment program for upper extremity injuries and pain. Mirror therapy can provide consistent visual feedback when performing upper extremity exercises. Mirror therapy applied after thoracotomy can reduce shoulder pain and kinesiophobia. The study was registered at clinicaltrials.gov (NCT05962736).